100 TOURNAMENT DRIVE

HORSHAM, PA 19044
T (267) 468-0350 // F (267) 468-0363
CREDIT CARD AUTHORIZATION FORM
I hereby authorize Turn 14 Distribution to charge my credit card as follows:

Keep this card on file as my: o Primary o Auto Back-up

CREDIT CARD INFORMATION

Credit Card Number

Cardholder Name 3 digit CVV2 Code (on back of

card)
Expiration Date

Company Name Cardholder’s Relation to Company

BILLING ADDRESS

Street Address

City State Country ZIP Code

If the billing address is not your business address, please provide an explanation:

Please note: While verifying your AVS Match (Address Verification System) on your card, you may
see a temporary pending charge of $1.00. This will reverse automatically.

Terms & Conditions:

Turn 14 Distribution imposes a surcharge of 3% on all sales paid through a credit card transaction under a non-US
based/ International account. This will be calculated and billed monthly. The monthly charge will be based on the credit card
transactions total and will be billed by the 5th of each new month. (This surcharge can be lessened or eliminated by paying via
Wire Transfer)
Turn 14 Distribution policy only accepts the company's business credit card or an owner's personal card. All other cards are
strictly prohibited.
Turn 14 Distribution policy states that credits will not be issued as a refund to credit cards. These credits will instead
remain as an open credit on your account to be applied to future balances owed.

I hereby certify that the above information is truthful and correct to the best of my knowledge. I understand that the presentation of false/
incorrect information entitles Turn 14 Distribution to revoke any and all credit terms granted at any time.
Cardholder Signature:

Phone Number: Date:

Fax to (267) 468–0363 or email to accounting@turn14.com